Provider Demographics
NPI:1144585514
Name:LASH, JEREMY L (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:L
Last Name:LASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 62106
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-2106
Mailing Address - Country:US
Mailing Address - Phone:805-898-3077
Mailing Address - Fax:805-898-3058
Practice Address - Street 1:317 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4365
Practice Address - Country:US
Practice Address - Phone:805-898-3077
Practice Address - Fax:805-898-3058
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA135005208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA135005OtherMEDICAL LICENSE